Is ED recovery easier when your body is “normative or stereotypically desirable”? The anon asking the question implied that recovery could be more difficult because “an obese person … will never stop hearing hearing extremely triggering stuff about their body type.” Anon asked, “Have there been any studies on this?” Andrea tackled this question in her last post (it might be helpful to read it first if you haven’t yet); in this post, I will expand on my original answer.
Assuming anon meant, “Have there been anything studies assessing whether recovery is harder for individuals who do not fit the normative body type (because of fat phobia/fat shaming/diet culture)?” Then, my answer is: Not really, or at least I couldn’t find anything evaluating this question directly.
I was only able to find a few studies commenting on the history of overweight or obesity as a predictor of recovery/treatment outcome (but there are probably more):
In the 1980s, a few studies came out suggesting that patients with bulimia nervosa (BN) require fewer calories for weight maintenance than anorexia nervosa patients (e.g., Newman, Halmi, & Marchi, 1987) and healthy female controls (e.g., Gwirtsman et al., 1989).
Gwirtsman et al. (1989), after finding that patients with bulimia nervosa required few calories for weight maintenance than healthy volunteers, had these suggestions for clinicians:
When bulimic patients are induced to cease their binging and vomiting behavior, we suggest that physicians and dietitians prescribe a diet in which the caloric level is lower than might be expected. Our experience suggests that some patients will tend to gain weight if this is not done, especially when hospitalized. Because patients are often averse to any gain in body weight, this may lead to grave mistrust between patient and physician or dietitian.
Among many things, this ignores the fact that patients with bulimia nervosa, despite being in the so-called “normal” weight range may not be at their healthy weight.
It is not possible to determine at this point whether the abnormality in
What does eating disorder recovery really look like? When you say the word “recovery,” differences of opinion loom large. The lack of definitional clarity around the concept of recovery came up many times at ICED, and continues to surface in discussions among researchers, clinicians, and individuals with eating disorders themselves. We’ve looked at recovery on the blog before (for example, Gina looked at how patients define recovery here; Tetyana surveyed readers about their perspectives on whether or not they thought of themselves as being in recovery and wrote about it here; I wrote about men’s experiences after recovery here). It’s something of a hot topic in the research literature, too.
My Master’s thesis focused primarily on recovery, with one “take home message” being that there can be a disconnect between what recovery means in treatment settings, in popular understanding, and among individuals who have experienced eating disorders. Of course, my study was qualitative and from a critical feminist standpoint, so it is still unclear how well my findings map onto the larger dynamics of recovery. Still, understanding …
I must admit that I cringe slightly every time I try to think about healthcare from an economics perspective. To me, this comes a little close to putting a dollar value on human beings, which feels uncomfortably post-humanistic to me. Nonetheless, there is no ignoring the ways in which economic concerns factor into policy decisions that drive our human services, including health care.
There are also a number of pragmatic reasons for thinking about the costs associated with illnesses; talking in dollars and cents can make for a convincing argument when seeking funding to do research on a particular illness, for example. The ability to reduce healthcare costs is incredibly compelling in a time of fiscal restraint.
Crow (2014) published a short article about the economic costs of eating disorder treatment. In this article, he highlights some recent studies that have examined factors related to “the economics of eating disorders” and suggests avenues for future research in this area.
I will preface my analysis by noting that healthcare economics are not my area of expertise, and I doubt …
If a person severely restricts his diet and exercises for hours each day, he has an eating disorder. If another does exactly the same but it is because she wants to make the lightweight rowing team (which has an upper weight limit), she’s a committed athlete. When the two overlap, and an athlete presents with eating disorder symptoms, how do we distinguish between the demands of the sport and the illness?
I’ve been interested in the distinctions we make between disordered and non-disordered eating and exercise behaviours for a while now. Recently, when I was browsing through articles, I came across a literature review by Werner et al. (2013) (open access) of studies examining weight-control and disordered eating behaviours in young athletes.
The authors start by noting the sheer lack of research that has actually been done in this area. This is worrying: typical onset of eating disorders is during adolescence, and research indicates that athletes are more likely to develop these disorders, leaving young athletes in what appears to be a high-risk position.
Werner et al. searched …
How did I ever find things to write about before social media? Recently, someone on Tumblr asked whether eating disorder prevention and awareness efforts do more harm than good. In other words, can attempting to prevent eating disorders actually contribute to their development? Good question, I thought. I’ve often wondered about this myself, especially in light of some emerging studies suggesting that “healthy eating” campaigns may actually contribute to unhealthy (restrictive) behaviours around food in school children. So off I went to scour the literature. I came up with a number of hits, but surprisingly few from the past few years. With this recent silence in mind, I will look specifically at a meta-analysis by Stice, Shaw & Marti published in 2007 that highlights some of the characteristics of effective prevention programs and comment on some of the potential pitfalls of prevention.
As a bit of a primer prevention efforts are generally divided into 3 types: primary, secondary and tertiary.
Arts-based therapies are often used to supplement more “traditional” eating disorder treatment protocols in various different settings, ranging from individual therapy to inpatient units. However, as Frisch, Franko & Herzog (2006) note, no published research provides empirical support for the use of arts-based therapies for eating disorder treatment.
You might be wondering: if there is no empirical support, why are clinicians still using these therapeutic practices? You might also be wondering why I’ve chosen to dissect an article from 2006.
I’ll address the first question in this post (teaser: it’s really hard to say!). As for my delving back into the depths of academia, there is surprisingly little literature that touches on arts-based therapy, despite its continued use. This article provides an overview of why this might be, and where we can go from here.
WHAT IS ARTS-BASED THERAPY?
Arts therapy is an umbrella term used to refer to the “medicinal use of creative arts,” including dance and movement, drama, music, and visual arts. The premise of arts-based therapy is that engaging with the arts will facilitate clients’ …
I recently attended the International Society of Critical Health Psychology’s 8th Biennial Conference in Bradford, England. At the conference, I had the pleasure of attending many talks that challenged the way we approach health psychology. Luckily for me, there were several sessions that touched on issues of disordered eating and body image.
One such talk, a panel presentation with Hannah Frith, Sarah Riley, Martine Robson and Peter Branney, challenged attendees to re-think the way we approach body image. When I returned home, I immediately downloaded an article by Kate Gleeson and Hannah Frith (2006) that discusses this same idea and essentially begs the question: Is the concept of “body image,” as it is currently articulated, actually useful?
This might come off as a controversial question; after all, body image is central to many studies (and treatment programs) related to eating disorders. We’re told repeatedly that by improving our body image, we can achieve peace with food, with ourselves, with exercise, and with others. Good body image is upheld as …